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Let's Talk About ED LET’S TALK ABOUT ED Get the facts. And get back to your life. This content is intended for patient counseling purposes only. This content is for informational/educational purposes and is not intended to treat or diagnose any disease or person. No claims are made as to the safety or eicacy of mentioned preparations. The compounded medications featured in this piece have been prescribed and administered by physicians who work with Wedgewood Pharmacy. You are encouraged to speak with your health care provider as to the appropriate use of any medication. TELL ED TO TAKE A HIKE 2 Let’s Talk About ED You’re not alone. A lot of guys know ED. Nearly More than % 30million 50 men have erectile of men between the ages dysfunction (ED) in the of 40 and 70 experience United States. it to some degree1. The bottom line is this – you’re not alone, and you don’t have to go it alone. This guide focuses on a treatment option prescribed for erectile dysfunction, penile self-injection medications, also known as intracavernosal injections. If you have any questions after reading this guide, bring them to your doctor’s attention. Don’t let ED be the boss of you. It’s natural to feel some anxiety about erectile dysfunction. But ED is a medical condition that can be treated – and treatment can result in signiicantly improved quality of life2 for both you and your partner. Many men report that enhancing or even saving a relationship, enjoying a satisfying sex life and regaining conidence far outweigh any anxieties about pursuing treatment – it’s well worth it. Common treatment options for ED include oral medications, injections, vacuum-tube devices, and penile prostheses. Talk about these options with your health care provider and, together, determine the best choice for you. WedgewoodRx.com/wp/TALK-ABOUT-ED 3 When pills don’t work. Penile self-injection medications are an option when pills are inefective. Success rates (i.e., obtaining an erection) for these injection medications may vary; however, according to one study, patients who have undergone prostatectomies have reported success rates as high as 85 percent to 95 percent3. In a second study, it was reported that injectable therapy provides a fairly natural-feeling erection4, which can mean more satisfaction in your sexual relationships5. Pain: What to expect. While the idea of sticking a needle into your penis may be a bit overwhelming, many men report that it’s the psychological anxiety of their irst self-injection – not the pain itself – that’s the problem. In fact, 40 percent of men in a recent study (Albaugh & Ferrans, 20096) rated the needle insertion pain at 0 (no pain) on a verbal pain scale of 0-10. For men who reported any pain, the average pain rating was only 1.33. Verbal Pain Intensity Scale % 40 of men reported no pain. average pain rating for 1.33 those men reporting pain. No Mild Moderate Severe Very Worst Pain Pain Pain Pain Severe Possible Pain Pain If you experience discomfort after the medication is injected, talk with your doctor. It may be as simple as a change in medication or a review of your injection technique. 4 Let’s Talk About ED Introduce your partner to ED. It’s important for men dealing with ED to take their partners’ feelings into consideration and keep them involved in the process, even asking them to attend doctors’ appointments with you. In most cases, partners feel they not only should be involved but need to be involved – to learn more about the medication, how it works, where to inject, adverse efects and other issues. When a man has a drug-induced erection, his partner may have feelings of resentment that he achieved it without the partner’s involvement and might even consider the erectile process as unnatural. This can be overcome by encouraging the partner to participate. With injectable therapy, the partner can do anything from illing the syringe to actually giving the injection. WedgewoodRx.com/wp/TALK-ABOUT-ED 5 ED Answers (Frequently Asked Questions) How do ED medications work? While oral medications increase blood low to the penis during sexual stimulation, penile injections use vasoactive medications (a pharmaceutical agent that has the efect of either increasing or decreasing blood pressure and/or heart rate) locally injected into the side of the penis to dilate the blood vessels of the penis causing penile engorgement7. Tri-Mix, an injectable medicine, has been shown in studies to work by relaxing the smooth muscle in the penis and opening the blood vessels causing an erection8. One study has shown that penile self-injection :15 medications cause an erection in 10 to 15 minutes that lasts up to one hour9; however, please note that it may take multiple visits to your health care provider to ind the right dose for an erection irm enough to have sex10. Your health care provider will guide you through this process. How, where and when do I self inject? The James Cancer Hospital & Solove Research Institute, The Ohio State University Medical Center has published a report, “Treatment for Erectile Dysfunction (ED): Injection of Medicine” (Copyright 2006 - June 2, 2010) that ofers guidelines for penile self-injection techniques. You may access this report via Wedgewood Pharmacy’s website: WedgewoodRx.com/wp/TALK-ABOUT-ED. How often can I use the medication? It is best to ask your doctor for guidance regarding how often you can use the medication; however, the James Cancer Hospital & Solove Research Institute recommends that you wait 24-48 hours between injections and limit use to three times a week11. 6 Let’s Talk About ED What if the medication doesn’t work or stops working? There may be times when there is “no response.” If this occurs, call your doctor. It may be a matter of adjusting the dosage or ensuring that the medication was injected in the recommended area of the penis. If you feel that you need a larger dose or stronger medication, discuss this with your doctor so you can work together to get the best results. What are the most common adverse efects? If the needle goes through a vein during self-injection, a hematoma (swelling of the vein) can occur12. If this happens, put pressure on the area with your hand. Bruising and bleeding may occur as well. If the erection lasts longer than one hour, talk to your health care provider about adjusting your dosage13. If you continue to have an erection after two hours, contact your physician. Some physicians may recommend taking four 30mg tablets of Sudafed (pseudoephedrine) 14. If you have a heart condition, check with your physician before using Sudafed or using any other medication. If your erection lasts for more than four hours – a serious medical condition known as priapism – you need to seek immediate medical attention to avoid permanent damage. The best course of action is to go to an emergency room for treatment without delay. When an erection is rigid for more than four hours, fresh blood low and oxygen to the penis is restricted. Tissue damage can occur if this is not treated. Not seeking treatment may result in permanent, untreatable ED15. To minimize the risks of such adverse efects, always follow your health care provider’s self-injection instructions, and be sure to consult with him or her if you have any questions or concerns. What kind of syringes should I use? Syringes/needles come in various gauges (thinness) and lengths. The commonly used syringe/needle size is 29g WedgewoodRx.com/wp/TALK-ABOUT-ED 7 (gauge), one-half inch; however, 31g is also popular (the higher the gauge, the thinner the needle). Ask your doctor about the needle gauge and length that may work best for you. What do I do with my used syringes? After the syringe is used, many place it into a thick plastic (detergent bottle, milk jug) or metal (cofee can) container that has a tight cap or screw- on lid. Make sure that the container is sealed before discarding in the regular trash (not the recycling). Before throwing away the container, you should seal the lid with heavy-duty tape. For more information, contact the Coalition for Safe Community Needle Disposal at 1-800-643-1643 or visit: WedgewoodRx.com/wp/TALK-ABOUT-ED. TRAVEL & DISCRETION Traveling with your medication is usually t hassle free. While you travel, you can keep your medication refrigerated by adding the vial to a bag of ice or storing it in a thermos. Another option is to acquire a medication travel kit that often includes a reusable freezer pack and can accommodate vials of the medication, alcohol swabs and syringes – either empty or pre-illed. By refreezing the gel pack, this kit can also be used to place your medication and syringes in places you feel are more discreet. You can also reuse the foam-based packaging container and freezer packs that are used to ship the medication. The Transportation Security Administration f (TSA) permits taking freezer packs or frozen gel packs that are required to keep medically necessary liquids cool through the screening (though they may be subject to additional screening). Supplies that are associated with medically necessary liquids, such as syringes, are allowed through a checkpoint once they have been screened by X-ray or inspection. The passenger should declare these items to an oicer and separate them from other belongings for screening. 8 Let’s Talk About ED How should the medication be stored? It’s best to keep the medication refrigerated and away from light.
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